Healthcare Provider Details

I. General information

NPI: 1780707539
Provider Name (Legal Business Name): ANDY JIN-HONG LAM D.C. O. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7955 W. SAHARA AVE #101
LAS VEGAS NV
89117
US

IV. Provider business mailing address

7955 W. SAHARA AVE #101
LAS VEGAS NV
89117
US

V. Phone/Fax

Practice location:
  • Phone: 702-405-6105
  • Fax: 702-405-7035
Mailing address:
  • Phone: 702-405-6105
  • Fax: 702-405-7035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-29761
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC-10809
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1027
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01187
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: